Genitourinary Flashcards
Features of kidney cancer
- most common type is RCC → malignant cancer of PCT epithelium
- often asymptomatic and discovered incidentally
- 25% have metastasis at presentation
Risk factors of kidney cancer
- haemodialysis
- smoking
- HTN
Presentation of kidney cancer
classic triad
- haematuria
- flank pain
- palpable abdominal mass
- classic cancer symptoms
- may present with varicocele
Investigations for kidney cancer
- US
CT chest/abdomen/pelvis
DIAGNOSTIC = renal biopsy
Management of kidney cancer
- full/partial nephrectomy
- mayo prognostic risk score → predict survival, guide treatment
Complications of kidney cancer
- polycythaemia
- HTN
- hypercalcaemia
- Cushings
Features of bladder cancer
- most common GU tract malignancy
- most common type = transitional cell carcinoma of bladder
Risk factors of bladder cancer
- 50-80
- male
- caucasian
- smoking
- pelvic radiation
- bladder stone due to chronic inflammation
- exposure to dye/rubber/leather/textiles/paint → hairdresser, painter
Presentation of bladder cancer
- painless haematuria → visible or non-visible
- urgency
- suprapubic/pelvis mass/pain
- recurrent UTI without bacteriuria
- systemic symptoms
Investigations for bladder cancer
haematuria clinic
- urinalysis → sterile pyuria
- CT urogram → staging
- bloods
- DIAGNOSTIC = flexible cystoscopy
Treatment for bladder cancer
- chemo
- radiotherapy
- symptomatic relief
- transurethral resection of bladder tumour
- cystodiathermy
- cystectomy
What is Goodpasture’s
- autoantibodies to type4 collagen in glomerular and alveolar membrane
- can cause rapidly progressing glomerulonephritis → renal failure
Presentation of Goodpasture’s
- SOB
- oliguria
Diagnosis of Goodpasture’s
anti-GBM autoantibodies in bloods and biopsy
Management of Goodpasture’s
- plasma exchange
- steroids
- cyclophosphamide → immune suppression
What is chlamydia?
- most common bacterial STI
- caused by chlamyrdia trachomatis
Presentation of chlamydia
men
- testicular pain
- voiding synptoms, dysuria
- 50% asymptomatic
women
- vaginal discharge and dysuria
- white/yellow/green discharge
- 70% asymptomatic
Diagnosis of chlamydia
nucleic acid amplification testing
Management of chlamydia
- avoid sex until treatment finished
- contact tracing
- single dose azithromycin
- 7 days doxycycline
What is gonorrhoea?
- caused by Neisseria gonorrhoea
- second most common STI
Presentation of gonorrhoea
- more likely to be asymptomatic
- men → dysuria, frequency , discharge
- women → vaginal discharge, dysuria, pelvic pain
Investigations for gonorrhoea
- NAAT
- microscopy → gram =ve diplococci
- culture → all infected areas with a swab
Treatment of gonorrhoea
- single ceftriaxone IM dose
